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Getting Ready for theMaryland Primary Care Program:Preview of CRISP Reporting ToolsProgram UpdateProgram Management Office& CRISP
TimelineTimelineCTOSelectionsCTO AnnouncedApplicationPeriod EndsMaryland Primary CareProgram ApprovalAnnouncementMay 14July 23Aug 1CTOArrangementsReleasedCTOLettersReleasedEarly NovEarly DecMaryland PrimaryCare ProgramBeginsJan 1Onboarding Submissions to CMS2018MayJuneJulAugSeptOctNov2019Dec2019TodayJune 8August 1August 31CTO ApplicationPeriod OpensPracticeApplicationPeriod OpensPracticeApplicationPeriod EndsEarlyOctPracticeLettersReleasedEarly DecPractice &CTO PAsReleasedDec 21Final Date forPractices &CTOs to Sign &Return AllAgreementsKeyCTO ActionPractice ActionDisclaimer: Guidance document only. Not endorsed by CMS. Timeline and exact dates subject to change.Program Milestone
Documents & FormsPractice Documents & ParticipationNovember Release: CTO Arrangement CRISP Participation Agreement Follow-upDecember Release: Practice Participation Agreement (PA) with CMS Practice Participation Agreement Data Worksheet Registration for data access Registration for Enterprise Policy Privacy Engine (EPPE) Registration for Enterprise Identity Management (EIDM) Account Register in December, Access in January Final deadline to return PA and Arrangement: Friday, December 213
Documents & FormsCTO ArrangementPractices select services, countersign, and return to CTO and MDH-PMOvia email at mdh.pcmodel@Maryland.gov by Dec. 21Terms 2 pages Defines and confirmsrelationship based on practiceOption selection Effective Jan 1 Renews Annually UnlessTerminated Care Management Fee Split Lead Care Manager Data Sharing Termination & Notification4Appendix A Details the services &staff offered by theCTO to all partnerpractices based onOption and Track Practices initial besideservices they want toselectAppendix B Business AssociateAgreement (BAA) Allows the CTO to haveaccess via CRISP to qualityand utilization reportsavailable to the Practice Practice is the CoveredEntity; CTO is the BusinessAssociate May be originated by eitherPractice or CTO
ParticipationPractice Vetting in Progress Participation contingent on vetting and document submission:1. Vetting Program integrity screening Attribution Minimum 125 Medicare FFS beneficiaries Primary Care Taxonomy Completion of vetting expected early Dec2. Document Submission - by December 215
CRISP Mission, Vision, ValuesOur VisionOur Guiding PrinciplesTo advance health and wellnessby deploying health informationtechnology solutions adoptedthrough cooperation andcollaboration.1. Begin with a manageable scope andremain incremental.Our Mission3. Affirm that competition and marketmechanisms spur innovation andimprovement.We will enable and support thehealthcare community of Marylandand our region to appropriately andsecurely share data in order tofacilitate care, reduce costs, andimprove health outcomes.2. Create opportunities to cooperate evenwhile participating healthcareorganizations still compete in other ways.4. Promote and enable consumers’ controlover their own health information.5. Use best practices and standards.6. Serve our region’s entire healthcarecommunity.3
CRISP Support for MDPCPCRISP has committed to support MDPCP in thefollowing three ways:1. CRISP will enable certain HIE tools whichparticipating practices must use to facilitate bettercare coordination.2. CRISP will provide claims-based reports to eachparticipating practice for tracking progress andproviding interventions.3. CRISP will aggregate the quality measuresubmissions from participating practices to submit toCMS.7
Claims-Based ReportsCRISP will provide standard reports to eachparticipating practice location and their CTO (asapplicable). These will be created by CRISP’spartner hMetrix based on Medicare claims data. ED visit rates for your practice Hospital admission rates for your practice Specialty referral patterns from your practiceThese reports will rely on CMS attribution files tolink Medicare beneficiaries with a practice location,and files to link practice locations with CTOs.8
Early Wireframe: Summary View9
Early Wireframe: Year-Over-Year Comparisons10
Early Wireframe: Benchmarking11
Early Wireframe: Trends12
Early Wireframe: Drilldown by Payments13
Early Wireframe: Payment Band14
Early Wireframe: Diagnosis15
Early Wireframe: IP/ER Utilization16
Early Wireframe: Professional Services17
Early Wireframe: Professional Services Filters18
Early Wireframe: Patient Details by Physician19
Early Wireframe: Patient Detail All Claims20
Thank you!Updates and More ions: email MarylandModel@cms.hhs.gov21
Maryland Primary Care Program Approval Announcement May 14 CTO Selections Announced Aug 1 Maryland Primary Care Program Begins Jan 1 Practice Application Period Ends August 31 . Associate May be originated by either Practice or CTO Terms 2 pages Defines and confirms relationship based on practice Option selection
